Sustainable Careers for Advanced Critical Care Practitioners (ACCPs)

Published 10/01/2023

Recommendations

  1. We encourage open dialogue whereby ACCPs can agree their working patterns in consultation with the unit clinical lead, consultant ACCP supervisor and where applicable the lead ACCP.
  2. With advancing seniority, and in consultation with the clinical lead or consultant ACCP supervisor, ACCPs may undertake additional non-clinical work to support the unit and the specialty of intensive care medicine. We advocate formal recognition of these roles and rostering them into a job plan that equates to 80/20 split of direct clinical care and supporting professional activities (SPA) respectively.
  3. As experienced ACCPs take on other roles, it is important to maintain a clinical commitment for the retention of skills, knowledge, capability and credibility. The FICM suggest that an ACCP’s clinical commitment should be agreed with the clinical lead/director and consultant ACCP supervisor. This should be regularly reviewed via appraisal, line management and job planning discussions.
  4. We encourage open dialogue between the unit clinical lead/director, consultant supervisor or lead ACCP with ACCPs aged over 55 on what constitutes an appropriate working pattern with advancing age. This must be tailored to the physical and psychological needs of the ACCP whilst recognising that critical care is a 24/7 specialty.
  5. We recommend 10 days of professional leave per year in addition to SPA time to support PDP targets agreed at appraisal for a full time ACCP, with a study budget commensurate with the requirements for AP.
  6. ACCPs, whether in training or qualified, must have a dedicated educational supervisor who is a consultant in critical care medicine. A consultant supervisor must have this educational commitment recognised in their job plan. We recommend 0.25PA per trainee ACCP and 0.125PA per trained ACCP, unless specific demands suggest that this should be amended.
  7. Staff new to the role of ACCP should be allocated a mentor. This should ideally be another more experienced ACCP in the same critical care unit; where this is not possible, a more experienced ACCP in a neighbouring unit within the same critical care Operational Delivery Network would be appropriate.
  8. ACCPs should be independently represented at critical care unit meetings and in the Advanced Practice workstreams within the Trust/Health Board. Where an ACCP is unable to attend, the consultant supervisor may represent their views.
  9. We encourage collaboration between all ACCPs within a Critical Care Operational Delivery Network for professional and psychosocial wellbeing. The views of ACCPs from within a region should be represented to their Critical Care Operational Delivery Network, via a named ACCP representative. 
  10. The physical working conditions and facilities for rest applicable to ACCPs should align with other resident doctors.
  11. Organisations who employ ACCPs, be they in training or following qualification, should align their banding structure with that described in this document. This follows the recommendations for advanced practice roles from the Centre for Advanced Practice, NHSE and the equivalent bodies in the devolved nations. Broadly: trainee ACCP (band 7), ACCP (band 8a), senior ACCP (band 8a or 8b – banding to be decided locally), lead ACCP (band 8b), ACCP consultant (band 8c).
  12. The knowledge, skills, attitudes, and experience that define each tier of ACCP seniority are described in this document.
  13. ACCPs working outside of the critical care unit must do so within an appropriate wrapper of education, supervision and governance, ensuring ACCPs continue to work within the framework described by the Centre for Advanced Practice and equivalent bodies in the devolved nations.